Have you noticed in all the excitement over reform of the NHS in England that David Cameron has taken to poking the NHS in Labour-dominated Wales for cuts being factored into the health budget in Cardiff?
He did so at prime minister’s question time before the May elections – when the 2011-12 budget had been struck by the Labour-Plaid Cymru coalition – and he’s done so again since 5 May when Labour won 30 of the 60 Welsh Assembly seats and decided to govern alone.
“Labour is cutting the NHS; you cannot trust Labour with our NHS” is Cameron’s message, although it is also a fact that London’s coalition has cut Cardiff’s block grant. Cardiff picks its priorities.
More to the point, the King’s Fund analysis by chief economist John Appleby also emerged to highlight expected real terms cuts across the UK health economy in the years ahead, more acute in Wales than in the other three home countries.
The think tank had to apologise to the Welsh government (Wales has just switched to the SNP preference and now uses “government”) for misreading the data so that its predicted real-terms cut after inflation will be 8.3 per cent and not 11 per cent as first stated.
Although the SNP administration at Holyrood has announced its budget for only one year, Professor Appleby’s estimate is that NHS Scotland will lose only 3.3 per cent of its budget in real terms (from a base where spending per head runs 15 per cent higher for all the usual historic reasons) while Northern Ireland’s loss is around 2.2 per cent.
It’s politically riskier for a Tory PM to poke them – so Wales presents a safer target, not least in a month when the SNP has been campaigning to oust Labour in Thursday’s Inverclyde by-election. Damaging Ed Miliband is a plus for Dave.
Thanks to Cameron’s own election pledge, of course, spending in England will be a little up or a little down, depending on who is doing the sums. But this column is rightly chided for Anglo-centricity, so let’s not go there (again) today.
Ask a senior Welsh Labour politician about the health budget cuts, as I did over the weekend, and he may reply: “We haven’t cut the health budget”, which is literally true in cash terms. But it doesn’t get us very far in making unavoidable hard choices when, on some estimates, NHS Wales was £400m overspent on its £6bn budget.
The back story involves Edwina Hart, feisty ex-trade union official and runner-up to Carwyn Jones in the contest to succeed Rhodri Morgan as first minister. As health minister she was involved in a silly row over an unpublished McKinsey report (not a report, an analysis) which criticised Wales’s much reorganised healthcare.
After 5 May she was moved to the business portfolio. Lesley Griffiths, for 20 years an NHS medical secretary in Wrexham, became the first health minister from north Wales. In her opening weeks she’s made some cautiously sensible noises, promising to extend GP opening hours at night and the weekends, to give a free “health MoT” to the over-50s and to keep free prescriptions – they “keep people in work and we know that worklessness leads to poor health”.
Griffiths promises to listen to frontline staff (“lots of friends”) but the overall agenda is familiar to us all: ambulance response times, unpopular hospital reorganisations and slipping waiting lists: measured by a 26 week target (not England’s 18 weeks) long waits are up, 25,000 against 9,000 last year. And, yes, care for the elderly is a rising problem in Wales too.
A tough challenge for a relative newcomer.